Electric stapler device

ABSTRACT

An end effector assembly adapted to couple to an electrosurgical instrument, the end effector assembly including a plurality of spaced apart small seal plates on opposing jaw members where each seal plate forms a pair of seal plates with the corresponding seal plate on the opposing jaw member. Each pair of seal plates is individually activatable, and the pair of seal plates are activated in sequence. When the opposing jaw members are in an approximated position, the pairs of seal plates around the periphery of each jaw member define a gap therebetween that is larger than the gap between pairs of seal plates along the center of each jaw member.

CROSS REFERENCE TO RELATED APPLICATION

The present application claims the benefit of and priority to U.S.Provisional Application Ser. No. 61/711,063, filed on Oct. 8, 2012, theentire contents of which are incorporated herein by reference.

BACKGROUND

Technical Field

The present disclosure relates to electrosurgical instruments used foropen and endoscopic surgical procedures. More particularly, the presentdisclosure relates to an apparatus with multi-circuit seal plates foruse in simulating staples with electronic seals.

Description of Related Art

Staples have traditionally been used to replace suturing when joining oranastomosing various body structures such as, for example, the bowel orbronchus. The surgical stapling devices employed to apply these staplesare generally designed to simultaneously cut and seal an extendedsegment of tissue in a patient, thus vastly reducing the time and risksof such procedures.

Linear or annular surgical stapling devices are employed by surgeons tosequentially or simultaneously apply one or more linear rows of surgicalfasteners, e.g., staples or two-part fasteners, to body tissue for thepurpose of joining segments of body tissue together and/or for thecreation of an anastomosis. Linear surgical stapling devices generallyinclude a pair of jaws or finger-like structures that otherwiseencompass or engage body tissue. When the surgical stapling device isactuated and/or “fired,” firing bars move longitudinally and contactstaple drive members in one of the jaws, and surgical staples are pushedthrough the body tissue and into/against an anvil in the opposite jawthereby crimping the staples closed. A knife blade may be provided tocut between the rows/lines of staples. Examples of such surgicalstapling devices are described in U.S. Pat. Nos. 4,354,628, 5,014,899and 5,040,715, the entirety of each of which is incorporated herein byreference.

Annular surgical stapling devices generally include an annular staplecartridge assembly including a plurality of annular rows of staples,typically two, an anvil assembly operatively associated with the annularcartridge assembly, and an annular blade disposed internal of the rowsof staples. Examples of such annular surgical stapling devices aredescribed in U.S. Pat. Nos. 5,799,857 and 5,915,616 to Robertson et al.,the entirety of each of which is incorporated herein by reference.

In general, an end-to-end anastomosis stapler typically places an arrayof staples into the approximated sections of a patient's bowels or othertubular organs. The resulting anastomosis contains an inverted sectionof bowel which contains numerous “B” shaped staples to maintain a secureconnection between the approximated sections of bowel.

SUMMARY

As used herein, the term “distal” refers to the portion that is beingdescribed which is further from a user, while the term “proximal” refersto the portion that is being described which is closer to a user.

As can be appreciated staples leave a foreign body in the patientnecessitating a need for a surgical device that creates a similarsurgical effect to a staple without leaving a staple within a patient.

According to one aspect of the present disclosure, an end effectorassembly adapted to couple to an electrosurgical instrument is disclosedand includes a plurality of spaced apart small seal plates on opposingjaw members where each seal plate forms a pair of seal plates with thecorresponding seal plate on the opposing jaw member. Each pair of sealplates is individually activatable, and the pair of seal plates areactivated in sequence. When the opposing jaw members are in anapproximated position, the pairs of seal plates around the periphery ofeach jaw member define a gap therebetween that is larger than the gapbetween pairs of seal plates along the center of each jaw member.

According to another aspect of the present disclosure, an end effectorassembly of a forceps includes first and second jaw members, at leastone of the jaw members moveable relative to the other between aspaced-apart position and an approximated position for grasping tissuetherebetween. Each jaw member includes a plurality of spaced apart sealplates, and each seal plate corresponds to a seal plate on the oppositejaw member to form a pair of seal plates, each pair of seal plates isindividually activatable. The jaw members further include a cuttingelement. When the first and second jaw members are in an approximatedposition, the pairs of seal plates closer to the cutting element definea gap therebetween that is smaller than the gap between pairs of sealplates further from the cutting element.

According to a further aspect of the present disclosure, the cuttingelement is located along a central axis on each jaw member.

According to another aspect of the present disclosure, each pair of sealplates receives electrical energy in a sequence.

According to a further aspect of the present disclosure, the pluralityof spaced apart seal plates are each attached to an insulator platewithout touching any other seal plates.

According to another aspect of the present disclosure, the end effectorassembly further includes at least one orifice within the insulatorplate configured to supply a clotting agent or factor and or a surgicaladhesive prior to supplying electrical energy to each pair of sealplates.

According to a further aspect of the present disclosure, the endeffector assembly includes a haptic feedback mechanism disposed withinthe forceps and configured to supply feedback to the user when each pairof seal plates receives an electrical signal.

According to another aspect of the present disclosure, an end effectorassembly of a forceps includes first and second jaw members with atleast one of the jaw members moveable relative to the other between aspaced-apart position and an approximated position for grasping tissuetherebetween. Each jaw member includes a plurality of spaced apart sealplates, and each seal plate corresponds to a seal plate on the oppositejaw member to form a pair of seal plates. Each pair of seal plates isindividually activatable. When the first and second jaw members are inthe approximated position, the pairs of seal plates around the peripheryof each jaw member define a gap therebetween that is larger than the gapbetween pairs of seal plates along the center of each jaw member

According to another aspect of the present disclosure, the end effectorassembly further includes a cutting element on at least one jaw member.The cutting element may be an electrical cutting element or a knifeblade.

According to another aspect of the present disclosure, the first andsecond jaw members are circular in shape and are moveable relative toone another along an axis aligned through the end effector assembly toallow for end-to-end anastomosis.

According to another aspect of the present disclosure, the end effectorassembly further includes at least one orifice configured to supply aseal aid to the seal plate.

According to another aspect of the present disclosure, a method forgenerating a plurality of electric staples includes the step of graspinga portion of tissue between a first and second jaw member. Each jawmember includes a plurality of spaced apart seal plates, and each sealplate corresponds to a seal plate on the opposite jaw member to form apair of seal plates with the pairs of seal plates defined along theperiphery of the jaw members defining a gap therebetween that is largerthan the gap between the pairs of seal plates along the center of eachjaw member. The method further includes the steps of sending anelectrical signal to a first pair of seal plates and sending anotherelectrical signal to a second pair of seal plates.

The method may further include the step of supplying a seal aid to atleast one seal plate prior to supplying an electrical signal thereto.

Alternatively or in addition, the method may include the step ofsupplying an audible sound or haptic feedback when the electricalsignals are sent to each pair of seal plates.

Alternatively or in addition, the plurality of spaced apart seal platesmay be separated by an insulator.

Alternatively or in addition, the method may include the step of varyinga seal strength by supplying an electrical signal to different pairs ofseal plates, wherein the gap between at least two pairs of seal platesis different. The gap defined between the first pair of seal plates maybe greater or smaller than the gap between the second pair of sealplates.

BRIEF DESCRIPTION OF THE DRAWINGS

Various embodiments of the present disclosure are described herein withreference to the drawings wherein:

FIG. 1A is a perspective view of an endoscopic forceps having an endeffector including a plurality of seal plates in accordance with anembodiment of the present disclosure;

FIG. 1B is a perspective view of forceps for use in an open surgicalprocedure having an end effector including a plurality of seal plates inaccordance with another embodiment of the present disclosure;

FIG. 2 is a perspective view of the end effector for use with theforceps of FIG. 1A and FIG. 1B in an open condition and including aplurality of seal plates;

FIG. 3 is a front, cross-sectional view of the end effector of FIG. 2 ina closed condition;

FIGS. 4A and 4B are top views of lower jaw member and upper jaw member,respectively in accordance with another embodiment of the presentdisclosure;

FIG. 5 is a schematic block diagram of an electrosurgical system for usewith an end effector including a plurality of seal plates according toan embodiment of the present disclosure;

FIGS. 6A-6C are top views of a jaw member in accordance with alternateembodiments of the present disclosure;

FIGS. 7A-7C are top views of a jaw member in accordance with alternateembodiments of the present disclosure;

FIG. 7D is a perspective view of an endoscopic forceps having a jawmember from FIGS. 7A-7C in accordance with an embodiment of the presentdisclosure;

FIG. 8 illustrates an end-to-end anastomosis device for use with analternate embodiment of the electrosurgical stapler device according tothe present disclosure; and

FIG. 9 is a flow chart for generating a plurality of electrosurgicalstaples in accordance with the present disclosure.

DETAILED DESCRIPTION

Embodiments of the present disclosure are described in detail withreference to the drawing figures wherein like reference numeralsidentify similar or identical elements.

In accordance with the present disclosure, generally an end effectorincludes an upper seal plate and a lower seal plate describedcollectively as seal plates. The seal plates according to the presentdisclosure are manufactured to include a plurality of seal platesegments. The seal plate segments are configured to be selectivelyenergized by a control circuit. Alternatively, two or more seal platesegments may be configured to be simultaneously energized by one or moreelectrical circuits. In this manner, tissue is selectively treated byone or more of the individual seal plate segments or sequentiallytreated by one or more of the circuits that connect to the various sealplate segments. As such, the end effectors according to the presentdisclosure are configured and/or customized such that the tissue, orseparate portions of the tissue, grasped between the jaw members, may beselectively treated.

Referring now to the figures, FIG. 1A depicts an endoscopic forceps 10for use in connection with endoscopic surgical procedures and FIG. 1Bdepicts an open forceps 10′ for use in traditional open surgicalprocedures. For the purposes herein, either an endoscopic instrument,e.g., forceps 10, or an open surgery instrument, e.g., forceps 10′, mayutilize an end effector in accordance with the present disclosure.Obviously, different electrical, optical and mechanical connections andconsiderations may apply to each particular type of instrument, however,the novel aspects with respect to the end effector assemblies describedherein and their operating characteristics remain generally consistentwith respect to both the endoscopic or open surgery designs.

Turning now to FIG. 1A, the endoscopic forceps 10 is coupled to anelectrosurgical generator 40, or other suitable surgical energy source.Forceps 10 is adapted to seal tissue using radiofrequency (RF) energy orother suitable electrosurgical energy including microwave, RF,ultrasonic, and light energy. For the purposes herein, the generator 40will be described using RF energy. Generator 40 is configured to provideelectrosurgical energy at any suitable RF frequency. For example,generator 40 may provide an energy signal having a frequency from about1 MHz to about 300 GHz.

Forceps 10 is coupled to generator 40 via a cable 34. Cable 34 isconfigured to transmit one or more RF energy signals and/or energycontrol signals between the generator 40 and the forceps 10. Forceps 10may alternatively be configured as a self-contained instrument thatincludes the functionality of the generator 40 within the forceps 10(e.g., an energy source, a signal generator, a control circuit, etc.).For example, forceps 10 may include a battery (not explicitly shown)that provides electrical energy, an RF generator (40) connected to thebattery and configured to generate one or more RF energy signals and amicroprocessor to perform measurement and control functions and toselectively delivery one or more RF energy signals to the end effector100.

Forceps 10 includes a housing 20, a handle assembly 22, a rotatingassembly 28, a trigger assembly 30 and an end effector 100. Forceps 10further includes a shaft 12 having a distal end 16 configured to engagethe end effector 100 and a proximal end 14 configured to engage thehousing 20 and/or the rotating assembly 28. Cable 34 connects to wires(not explicitly shown) in the housing 20 that extend through the housing20, shaft 12 and terminate in the end effector 100 thereby providing oneor more electrical energy signals to the upper and lower sealing plates112, 122.

Handle assembly 22 includes a fixed handle 26 and a moveable handle 24.Fixed handle 26 is integrally associated with housing 20 and movablehandle 24 is movable relative to the fixed handle 26 to actuate the endeffector 100 between an open condition and a closed condition to graspand treat tissue positioned therebetween. Rotating assembly 28 isrotatable in a clockwise and a counter-clockwise rotation to rotate endeffector 100 about longitudinal axis “X-X.” Housing 20 houses theinternal working components of forceps 10.

End effector 100 includes upper and lower jaw members 110 and 120 eachhaving a proximal end and a distal end, respectively. Jaw members 110and 120 are pivotable about a pivot 19 and are movable between a firstcondition wherein jaw members 110 and 120 are closed and mutuallycooperate to grasp, seal and/or sense tissue therebetween (See FIGS. 1Aand 1B) and a second condition wherein the jaw members 110 and 120 arespaced relative to another (See FIG. 2).

Each jaw member 110, 120 includes a tissue contacting surface 112, 122,respectively, disposed on an inner-facing surface thereof. Tissuecontacting surfaces 112 and 122 cooperate to grasp tissue positionedtherebetween and are configured to coagulate and/or seal tissue uponapplication of energy from generator 40. Tissue contacting surfaces 112and 122 may be further configured to cut tissue and/or configured toposition tissue for cutting after tissue coagulation and/or tissuesealing is complete. One or more of the tissue contacting surfaces 112,122 may form part of the electrical circuit that communicates energythrough the tissue held between the upper and lower jaw members 110 and120, respectively.

Trigger assembly 30 may be configured to actuate a knife (e.g., knifeassembly 186, See FIG. 4A) disposed within forceps 10 to selectivelycut/sever tissue grasped between jaw members 110 and 120 positioned inthe first condition. Switch 32 is configured to selectively provideelectrosurgical energy to end effector assembly 100.

Referring now to FIG. 1B, an open forceps 10′ is depicted and includesend effector 100′ attached to a handle assembly 22′ that includes a pairof elongated shaft portions 12 a′ and 12 b′. Each elongated shaftportion 12 a′, 12 b′ includes a respective proximal end 14 a′, 14 b′ anda distal end 16 a′, 16 b′. The end effector assembly 100′ includes upperand lower members 110′, 120′ formed from, or attached to, eachrespective distal end 16 b′ and 16 a′ of shafts 12 b′ and 12 a′. Shafts12 a′ and 12 b are attached via pivot 19′ and are configured to pivotrelative to one another thereby actuating the jaw members 110′, 120′between the first condition and the second condition, as describedhereinabove.

Shafts 12 a′ and 12 b′ include respective handles 17 a′ and 17 b′disposed at the proximal ends 14 a′ and 14 b′ thereof. Handles 17 a′ and17 b′ facilitate scissor-like movement of the shafts 12 a′ and 12 b′relative to each other, which, in turn, actuate the jaw members 110′ and120′ between a first condition and a second condition. In the firstcondition, the jaws 110′ and 120′ are disposed in spaced relationrelative to one another and, in a second condition, the jaw members 110′and 120′ cooperate to grasp tissue therebetween.

In some embodiments, one or more of the shafts, e.g., shaft 12 a′,includes a switch assembly 32′ configured to selectively provideelectrical energy to the end effector assembly 100′. Forceps 10′ isdepicted having a cable 34′ that connects the forceps 10′ to generator40 (as shown in FIG. 1). Switch assembly 32′ is configured toselectively delivery the electrically energy from the generator 40 tothe seal plates (not explicitly shown, see seal plates 112, 122 in FIGS.2 and 3). Switch assembly 32′ may also be configured to select theelectrosurgical energy delivery mode and/or the delivery sequencing aswill be discussed hereinbelow.

Trigger assembly 30′ is configured to actuate a knife assembly 186, asdescribed with respect to FIG. 2 hereinbelow, disposed within forceps10′. The proximal end of the knife assembly 186 (See FIG. 4A) connectsto trigger assembly 30′ within the shaft 12 b′ of the forceps 10′. Knifeassembly 186 extends through shaft 12 b′ and forms a distal cutting edgeon the distal end thereof (See FIG. 4A). Knife assembly 186, whenactuated by trigger assembly 30′, extends the distal cutting edgedistally through a knife channel 115 (see FIG. 4A) to sever tissuepositioned between the jaw members 110′ and 120′.

With reference to FIG. 2, each seal plate 112, 122 forms a planarsealing surface that includes a plurality of seal plate segments 112a-112 f and 122 a-122 f, respectively, electrically isolated from eachother by insulating members 125 a, 125 b. Each seal plate segment 112a-112 f on the top jaw 110 has an opposing seal plate segment 122 a-122f on the bottom jaw 120 that form each pair of seal plate segments (pairof electrodes). Each seal plate segment 112 a-112 f and 122 a-122 fforms a substantially equal portion of the planar sealing surface,however the thickness of each seal plate segment may vary (See FIG. 3).The number of seal plates segments 112 a-112 f, 122 a-122 f on the jawmembers may vary as with the number of seal plate segments along axis“X-X” and perpendicular to axis “X-X.”

Insulating members 125 a and 125 b may be formed from any suitableinsulating material or dielectric material that provides electricalisolation between the seal plate segments 112 a-112 f and 122 a-122 f.Insulating members 125 a and 125 b may be formed from apolytetrafluorethylene (PTFE), polypropylene,polychlorotrifluoroethylene (IPCTFE), polyethylene,polyethyleneterephthalate (PET), polyvinylchloride (PVC), a ceramicmaterial or even air in a gap formed between adjacent seal segments. Theinsulating members 125 a and 125 b provide areas grasped within the endeffector 100 that are not sealed and therefore receive less tissuedamage to allow the body to generate the remainder of the seal withhealthy tissue.

The individual seal plate segments 112 a-112 f and 122 a-122 f may bepre-selected, or dynamically selected, as part of one or more electricalcircuits that deliver electrosurgical energy to tissue positionedbetween the jaw members 110 and 120. For example, in one configurationthe end effector 100 may include a first bipolar circuit that includesthe inner seal plate segments 112 a and 122 a, a second bipolar circuitthat includes the middle seal plate segments 112 b and 122 b and a thirdbipolar circuit that includes the outer seal plate segments 112 c and122 c wherein the first, second and third bipolar circuits areindependently enabled and/or controlled to deliver electrosurgicalenergy to tissue.

The seal plate segments on each jaw (e.g., lower seal plate segments 122a-122 f on lower jaw 120) are arranged such that the seal plate segmentsare positioned in rows and columns. The number of rows and columns canbe varied to control the number of individual seals caused by a singlegrasp of tissue by the end effector 100. The seal plate segments 112a-112 f on the upper seal plate 112 may have corresponding seal platesegments 122 a-122 f on the lower seal plate 122 positioned oppose andone another, as illustrated in FIGS. 2 and 3.

With reference to FIG. 3, the seal segments 112 a-112 f and 122 a-122 fare arranged such that the seal segments 112 c-112 d and 122 c-122 dclosest to the central axis “A-A” have a greater thickness t3. Also,when jaws 110 and 120 are in the closed position, the gap g3 betweensegments 112 d and 122 d, and similarly between segments 112 c and 122 cis the smallest. This creates the tightest seal in the center or closestto the cut if there is a knife blade 184 (see FIG. 4A) (or electricalcutter 610) along the central axis “A-A.” The smallest gap g3 createsthe highest compression seal which limits the acute bleeding. Morespecifically, the seal in the center may be about 3.5 to about 4.5 timessystolic pressure, although the desired pressure range may varydepending on tissue type or other factors. As you move left or rightalong Axis B-B from the central axis “A-A” the thickness of the sealsegments 112 e-112 f, 112 b-112 a, 122 e-122 f, and 122 b-122 a issmaller. In other words the thickness t2 of 112 e is greater than thethickness t1 of 112 f. Therefore, when the jaws 110, 120 are in a closedposition, the gap increases as you move left or right away from thecentral axis “A-A” along axis “B-B.” In other words the gap g2 between112 b and 122 b is smaller than the gap g1 between 112 a and 122 a, andtherefore the seal in the middle may be about 2.5 to 3.5 times systolicpressure at each seal. The medium gap g2 allows for medium compressionof tissue. The larger gap g1 allows for a lower compression whichreduces tissue damage. The largest gap seal allows for about 1.5 toabout 2.5 times systolic pressure at each seal although, similarly asnoted above, the desired pressure range may vary depending on tissuetype or other factors.

With reference to FIGS. 4A and 4B, knife channel 115 is defined by achannel formed within one or both jaw members 110 and 120 to permitreciprocation of knife assembly 186 therethrough, e.g., via activationof the trigger assembly 30, 30′ (See FIGS. 1A and 1B). The upper jawmember 110 and the lower jaw member 120, while in a closed position forma knife channel 115 therebetween. Knife channel 115 includes an upperknife channel 115 b, formed in the upper jaw member 110, mated with alower knife channel 115 a, formed in the lower jaw member 120.

Alternatively, instead of a knife blade assembly 186, the end effector100 may include an electrical cutting electrode 610 (See FIG. 6B) on thelower 110 and/or upper jaw member 120.

The seal segments 122 a-122 f and 112 a-112 f decrease in thickness asthe distance increases from the knife channel 115 or electrical cutter610 (see FIG. 6B). This allows for greatest compression closest to theknife blade 184 or the electrical cutter 610, which creates the tightestseal to prevent acute bleeding. The lowest compression is formed withthe seal segments 122 a, 112 a, 122 f, and 112 f furthest from the knifechannel 115 or electrical cutter 610, which allows for more bloodprofusion between the seal plates 122 a, 112 a, 122 f, and 112 f toallow the patient's body to slowly generate a long term seal. The numberof seal segments 112 a-112 f and 122 a-122 f may vary and therefore thegradient of compression applied between each seal segment can vary.

Turning now to FIG. 5, a system schematic block diagram for driving anend effector 100 according to the present disclosure is indicated assystem 1000. System 1000 includes a generator 40, a forceps 10 with amulti-seal circuit end effector 100 connected by a cable 34. Thegenerator 40 includes a controller 42, a power supply 44, an RF outputstage 46, a sensor module 48 and a multiplexer 60. The power supply 44provides DC power to the RF output stage 46 that converts the DC powerinto one or more RF energy signals. The one or more RF energy signalsare individually provided to the multiplexer 60.

The controller 42 includes a microprocessor 50 having a memory 52 whichmay be volatile type memory (e.g., RAM) and/or non-volatile type memory(e.g., flash media, disk media, etc.). The microprocessor 50 includes aconnection to the power supply 44 and/or RF output stage 46 that allowsthe microprocessor 50 to control the output of the generator 40according to an open-loop and/or closed-loop control scheme. The powersupply 44, RF output stage 46, multiplexer 60 and sensor module 48 areconnected to, and controlled by, the controller 42 and configured tooperate in concert to perform a selected surgical procedure.

For example, controller 42 may instruct the multiplexer 60 to connect anRF energy signal generated by the RF output stage 46 between any two ormore segments of the end effector 100. For example, multiplexer 60 maybe instructed by the controller 42 to form an electrosurgical energydelivery circuit between with seal plate 112 a on the upper jaw member110 and the seal plate 122 a on the lower jaw member 120 (See FIG. 2).Additionally, controller 42 may instruct the multiplexer 60 to connectthe sensor module 48 between any two or more segments of the endeffector 100 and controller 42 may instruct the sensor module 48 toperform a measurement between the selected segments of the end effector100. For example, multiplexer 60 may be instructed by the controller 42to form a measurement circuit between the seal plate segment 112 b onthe upper jaw member 110 and the seal plate segment 122 b on the lowerjaw member 120 (See FIG. 2). Controller 42 may issue instructions to thevarious components in the generator 40 to performed energy delivery andmeasurements sequentially or simultaneously.

Controller 42, in executing a closed-loop control scheme, may instructthe multiplexer 60 to simultaneously connect two segments on the endeffector 100 to the RF output stage 46 for delivery of electrosurgicalenergy and may further instruct the multiplexer to connect the sensormodule 48 to two segments on the end effector 100 wherein the sensormodule 48 provides feedback to the controller 42 for an energy deliverycontrol loop (e.g., the sensor module 48 includes one or more sensingmechanisms/circuits for sensing various tissue parameters such as tissueimpedance, tissue temperature, output current and/or voltage, etc.). Thecontroller 42, using the energy delivery control loop, signals the powersupply 44 and/or RF output stage 46 to adjust the electrosurgical energysignal.

The controller 42 also receives input signals from the input controls ofthe generator 40 and/or forceps 10, 10′. The controller 42 utilizes theinput signals to generate instructions for the various components in thegenerator 40, to adjust the power output of the generator 40 and/or toperform other control functions. The controller 42 may include analogand/or logic circuitry for processing input signals and/or controlsignals sent to the generator 40, rather than, or in combination with,the microprocessor 50.

The microprocessor 50 is capable of executing software instructions forprocessing data received by the sensor module 48, and for outputtingcontrol signals to the generator 40, accordingly. The softwareinstructions, which are executable by the controller 42, are stored inthe memory 52 of the controller 42.

The sensor module 48 may also include a plurality of sensors (notexplicitly shown) strategically located for sensing various propertiesor conditions, e.g., tissue impedance, voltage (e.g., voltage at thegenerator 40 and/or voltage at the tissue site) current (e.g., currentat the generator 40 and/or current delivered at the tissue site, etc.)The sensors are provided with leads (or wireless) for transmittinginformation or signals to the controller 42. The sensor module 48 mayinclude control circuitry that receives information and/or signals frommultiple sensors and provides the information and/or signals, and/or thesource of the information (e.g., the particular sensor providing theinformation), to the controller 42.

The sensor module 48 may include a real-time voltage sensing system anda real-time current sensing system for sensing real-time values relatedto applied voltage and current at the surgical site. Additionally, anRMS voltage sensing system and an RMS current sensing system may beincluded for sensing and deriving RMS values for applied voltage andcurrent at the surgical site.

The generator 40 includes suitable input controls (e.g., buttons,activators, switches, touch screen, etc.) for controlling the generator40, as well as one or more display screens for providing the surgeonwith information (e.g., intensity settings, treatment completeindicators, etc.). The controls allow the surgeon to adjust power of theRF energy, waveform, and other parameters to achieve the desiredwaveform suitable for a particular task (e.g., surgical procedure suchas tissue ablation, coagulation, cauterization, resection or anycombination thereof). Further, the forceps 10, 10′ may include one ormore input controls, some of which may be redundant, with certain inputcontrols included in the generator 40. Placing select input controls atthe instrument 10, 10′ allows for easier and faster modification of RFenergy parameters during the surgical procedure without requiringinteraction with the generator 40.

Returning to FIG. 2, the control circuit (e.g., controller 42) may beconfigured to dynamically select one or more of the seal plate segments112 a-112 c and 122 a-122 c before and/or during the surgical procedureand may be configured to dynamically switch the selected seal platesegments that form one or more of the electrosurgical energy deliverycircuits. More specifically, the control circuit (e.g., controller 42)may be configured to provide electrosurgical energy to the first bipolarcircuit during a simulated stapling action, configured to provideelectrosurgical energy to the second bipolar circuit during a secondsimulated stapling action and configured to provide electrosurgicalenergy to the third bipolar circuit during a third simulated staplingaction. In operation, the controller 42 instructs the multiplexer 60 todirect an RF energy signal, generated by the RF output stage 46, to eachof the first, second, etc. bipolar circuits during the simulatedstapling actions. The simulated stapling actions may be executedconsecutively, simultaneously, sequentially, or any portion of asimulated stapling action may overlap any other treatment simulatedstapling action.

As each simulated stapling action is performed by the generator 40sending an electrical signal to a pair of seal plates, for example 122 aand 112 a, the generator 40 may provide a ratcheting sound through aspeaker (not shown) in the generator 40 or the hand held device 10 or10′. Alternatively, the generator 40 may provide haptic feedback througha haptic mechanism (not shown) in the hand held device 10 or 10′ when asignal is sent to the pair of seal plates, for example 122 a and 112 a,similar to feedback felt when using a traditional stapling end effector.

Referring now to FIGS. 6A-6C, which show different embodiments of sealplate segments that may be generated along each jaw member 110 and/or120. FIG. 6A shows a jaw member 620 with staggered seal plate segments622 a-622 f. Between each seal segment is an insulative material 125.The insulative material provides an area of unsealed tissue between eachseal similar to how traditional staples form seals. FIG. 6B shows a jawmember 630 with diagonal seal segments 722 a-722 f. FIG. 6C shows a jawmember 640 with diagonal seal segments 822 a and 822 f, and staggeredseal plate segments 822 b-822 e. Only one jaw member is shown in FIGS.6A-6C, however, the opposite jaw member would have a similar look to thejaw member shown so that each seal plate segment forms a seal platesegment pair with the opposite seal plate segment on the opposing jawmember. The different possible arrangements of seal plate segments 622a-622 f, 722 a-722 f, and 822 a-822 f allow for different sealstrengths. Additionally, the thickness of the seal plate segments 612a-612 f varies similar to seal plate segments 112 a-112 f and 122 a-122f shown in FIG. 3.

Referring to FIGS. 7A-7D, the end effector 100 may provide seal aid asthe seal is generated. The seal aid may include a clotting factor, suchas Fibrin, and or adhesive. FIG. 7A shows one embodiment that includesorifice rings 750 around each seal segment 122 a-122 d. Such that aseach seal segment is activated, the seal aid is delivered through thejaw member 710 to reduce bleeding or “oozing.” Alternatively, as shownin FIG. 7B, the jaw member 720 may include orifices 760 between eachseal segment 122 a-122 d. Both jaw member 710 and 720 allow for the useof an electrical cutter 610 because the orifices 750 or 760 are aroundor near the seal segments 122 a-122 d. FIG. 7C shows another alternativefor supplying seal aid near the seal that allows the seal aid to oozefrom the knife channel 115 or through specific orifices 770 in the knifechannel 115. Another alternative, is to have the seal aid applieddirectly to each seal plate segment and as each seal plate segment heatsup when receiving the electrical energy the seal aid is applied to theseal.

FIG. 7D shows a surgical device 10 that includes a container 780 forstoring pressurized seal aid that is supplied when trigger 785 isselected by the user. The pressurized seal aid is supplied to one ormore jaw members 110 and or 120 through lumen 790. The seal aid thenapplies to the seal through orifices 750, 760, or 770 from lumen 790.

End effector 100 may also include a lumen (not shown) that receives acooling liquid from the surgical device 10. The cooling liquid assistsin reducing tissue damage near each activated seal plate segment 122a-122 f or 112 a-112 f by reducing the temperature of end effector 100,and therefore reducing tissue damage near each seal plate segmentbecause the insulative material 125 remains at lower temperature.

Surgical device 10 may be adapted for use as an end-to-end anastomosis(EEA) apparatus 2000 (FIG. 8), such as that disclosed in U.S. Pat. No.7,455,676, the contents of which are hereby incorporated by referenceherein in its entirety. The EEA apparatus 2000 includes a handleassembly 2002 having at least one pivotable actuating handle member2004, and advancing means 2006. Extending from handle assembly 2002,there is provided a tubular body portion 2008 that terminates in afastener ejection (tool) assembly 2010 having a first circularelectrical stapler member 2012 that includes a plurality of sealsegments 2122 a-2122 c in a circular pattern. The seal plate segments2122 a-2122 c are located on both the first circular electrical staplermember 2012 and a second circular electrical stapler member 2016. Thefirst and second circular electrical stapler members 2012, 2016 areconnected together through shaft 2014.

When the first and second circular electrical stapler members 2012, 2016are in a closed position, the seal plate segments 2122 a-2122 c are eachpaired with an opposing seal segment on the opposite circular electricalstapler member. The smallest gap is formed between the pair of sealsegments 2122 c on the inner most ring of the first and second circularelectrical stapler members 2012, 2016. The smallest gap allows for themost compression and therefore the “tightest” or highest quality oracute seal. The middle row of seal segments 2122 b provides a slightlylarger gap and a medium amount of compression. The gap is the largestbetween seal segments 2122 a in the outer most ring, which provides thelowest compression and allows for the least “tightest” seal. Inalternative embodiments the number of rings of segments may vary andtherefore the varying gap/compression will vary too.

FIG. 9 discloses a flow chart for using an electronic stapler device 10,10′, 2000 to simulate staples during a surgical procedure. The process900 starts at step 905 and at step 910, the surgeon grasps tissue withend effector 100. Next at step 920, the surgeon cuts the tissue ifnecessary using a knife blade 184 or electrical cutter 610.Alternatively, the tissue may be cut between two seals. Then at step930, the generator 40 sends an electrical signal to a first electrodepair after the surgeon hits a trigger button on the electronic staplerdevice 10. Whenever the signal is sent from the generator 40, thegenerator 40 may provide a ratcheting sound or haptic feedback to informthe surgeon that a signal was sent and that a electric staple seal wasformed. The first electrode pair may create the “tightest” or highestquality, or acute seal, i.e. between 122 c and 112 c (see FIG. 3), tocreate an acute seal first. Then at step 940, an electrical signal issent to the a second electrode pair, i.e. between 112 b and 122 b, tocreate a medium “tight” seal. Then at 950, an electrical signal is sentto a third electrode pair, i.e. between 112 a and 122 a, to create theleast “tightest” seal.

Alternatively, the first electrode pair may create the least “tightest”seal, i.e. between 122 a and 112 a (see FIG. 3), which pushes inward anyblood or other fluids directionally during sealing and controlsprofusion of fluids at the time of sealing. The second electrode, i.e.between 112 b and 122 b, receives the second electrical signal to createa medium “tight” seal. Then, the third electrode pair, i.e. between 112c and 122 c, receives the electrical signal to create the “tightest”seal (higher quality or acute seal).

In another alternative embodiment, the sequence may sequentially send anindividual signal to each seal plate pair that generates an acute seal.Then, the sequence may sequentially send an individual signal to eachseal plate pair that generates a medium “tight” seal. Finally, thesequence may sequentially send an individual signal to each seal platepair that generates the least “tightest” seal.

The process 900 ends at step 965, when each electrode pair has beenindividually fired on the end effector 100 or the seal is complete atstep 960. Additionally, as each pair of seal plate segments receives anelectrical signal, the surgeon may select to supply a seal aid to theseal. Also, the end effector 100 may also include a cooling liquidsupplied through lumens to cool the end effector 100 and reduce damageto tissue near a seal from the end effector 100 being too hot.

In alternative embodiments, more than one seal plate segment 112 a-112 fand 122 a-122 f may receive an electrical signal at the same time,however the goal is to reduce tissue damage to tissue near an energizedseal plate segment by reducing the heat dissipated to the non-sealedtissue.

While several embodiments of the disclosure have been shown in thedrawings and/or discussed herein, it is not intended that the disclosurebe limited thereto, as it is intended that the disclosure be as broad inscope as the art will allow and that the specification be read likewise.Therefore, the above description should not be construed as limiting,but merely as exemplifications of particular embodiments. Those skilledin the art will envision other modifications within the scope and spiritof the claims appended hereto.

What is claimed:
 1. An end effector assembly of a forceps, comprising:first and second opposing jaw members, at least one of the jaw membersmoveable relative to the other between a spaced-apart position and anapproximated position for grasping tissue therebetween, each jaw memberincluding: a plurality of spaced apart seal plates, wherein each sealplate corresponds to a seal plate on the opposing jaw member to form apair of seal plates, each pair of seal plates is individuallyactivatable, the plurality of spaced apart seal plates each attached toan insulator plate without touching any other seal plates; a cuttingelement, wherein when the first and second jaw members are in theapproximated position, the pairs of seal plates closer to the cuttingelement define a gap therebetween that is smaller than the gap betweenpairs of seal plates further from the cutting element; and at least oneorifice within at least one insulator plate configured to supply aclotting factor and or a surgical adhesive prior to supplying electricalenergy to each pair of seal plates.
 2. The end effector assemblyaccording to claim 1, wherein the cutting element is located along acentral axis on each jaw member.
 3. The end effector assembly accordingto claim 1, wherein each pair of seal plates receives electrical energyin a sequence.
 4. The end effector assembly according to claim 1,further comprising a haptic feedback mechanism disposed within theforceps and configured to supply feedback to the user when each pair ofseal plates receives an electrical signal.
 5. The end effector assemblyaccording to claim 1, wherein the cutting element is an electricalcutting element.
 6. The end effector assembly according to claim 1,wherein the cutting element is a knife blade.
 7. The end effectorassembly according to claim 1, wherein the first and second jaw membersare circular in shape and are moveable relative to one another along anaxis aligned through the end effector assembly to allow for end-to-endanastomosis.